Diabetes and arterial hypertension

ABSTRACT. The epidemiology, pathogenesis, significance and management of hypertension i diabetic subjects are discussed. The frequency of hypertension in the diabetic population is about 20 %. Microangiopathy which leads to increased peripheral resistance and subsequently to impaired kidney function is probably the most important factor in the pathogenesis of hypertension in diabetes. All antihypertensive drugs have particular limitations in the diabetic patient. However the blood pressure must be treated more aggressively than in nondiabetics. Today we know that complications in well controlled diabetics occur later and to a lesser degree than in poorly controlled diabetics. Drugs that have an unfavourable effect on the metabolic processes in diabetes should, if possible, be avoided. Key words: Hypertension, Type 1 diabetes, Type 2 diabetes, diabetic complications, nephropathy, retinopathy, obesity, antihypertensive drugs.